Ch 56 - Fractures of the Pelvis Flashcards

1
Q

What % of pelvic fractures have fractures at three or more sites in the pelvis?

A

76%

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2
Q

What percentage of pelvic fractures affect the weight bearing axis?
Bilateral weight bearing axis?

A

Unilateral 89%
Bilateral 39%

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3
Q

What % of pelvic fractures have urinary tract trauma?
How many require surgery?

A

39%
16% require surgery

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4
Q

What is the most common cause of neuro injury secondary to pelvis fractures?

How many have permanent neuro dysfunction?

A

Injury to the lumbosacral trunk associated with craniomedial displacement of iliac fractures (91%)

15% permanent

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5
Q

Do caudal acetbaular fractures need surgical fixation?

A

Controversial
- Animals seem to weight bear and be more comfortable than with other acetabular fractures
- Two studies have demostrated that the caudal acetabulum DOES have a important weight-bearing role
- Long term follow up of conservatively managed cases has shown unsatisfactory results for lameness and pain associated with significant DJD
- Often difficult to reduce and stabilise

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6
Q

What is the common obliquity of ilial fractures?

A

Cranioventral to caudodorsal

Usually cranially and medially displaced

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7
Q

What are some techniques of reducing ilial fractures?

A
  • Direct fragment manipulation
  • Gentle leveling
  • Lifting proximal femur
  • Separateapproach to tuber ischii and use of a Kern bone-holding forcep
  • Using the implant
  • Forceps sliding maneuver
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8
Q

What are the surgical options for ilial fractures?

A
  • Bone plating (lateral, dorsal, ventral)
  • ESF
  • Lag screws
  • Composite fixation

Dorsal plating in cats has shown less screw loosening and less canal narrowing

Plates: 2.7mm cats/small dogs, 2.7-3.5mm medium/large dogs)

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9
Q

What is secondary acetabular protrusion?

A

Medial luxation of the femoral head inside the pelvic canal following acetabular fracture

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10
Q

What is the prognosis for acetabular fractures?

A

generally very good!
- 83% occassional or no lameness
- 83% reduced mid-thigh circumference

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11
Q

What % of SI luxations are bilateral?

A
  • 23% in dogs
  • 18% in cats
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12
Q

What are the fixation options for SI luxations?

A
  • Lag screw
  • Transiliosacral rod or screw
  • Transilial pinning
  • Pin and tension band
  • Ventral screw placement
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13
Q

Where is the ideal location of the screw in the sacral body?
Inserted at what angle?

A

Inserted at 100 +/- 4.7 degrees in dogs
97 +/- 6.9 degrees in cats

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14
Q

What are the landmarks for screw placement in the wing of the ilium for a SI lag screw?

A
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15
Q

What is the recommend screw size for SI lag screw?

A
  • 2.0/2.7mm cats and small dogs
  • 3.5/4.0mm for medium dogs
  • 4.5/6.5mm for large dogs
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16
Q

How is SI screw loosening associated with depth of penetration?

A
  • Less than 60% of sacral width, 38% loosening
  • More than 60% width, 7% loosening
17
Q

What are the 5 types of sacral fracture?

A
  • Type I: Alar
  • Type II: Foraminal
  • Type III: Transverse
  • Type IV: Avulsion
  • Type V: Comminuted

69% have neuro dysfunction

18
Q

What percentage of pelvic fractures does the pelvic floor account for?

A

60%

19
Q

What are the surgical options for pelvic floor fractures?

A
  • Interfragmentary wire
  • Plates
  • Pin and tension band
  • Lag screws